Analysis Of The Risk Factors In Patients With Ventricular Aneurysm Post Acute ST-segment Elevation Myocardial Infarction Of Single Center

Objective:In order to further explore the risk factors of ventricular aneurysm(VA)formation after acute ST-segment elevation myocardial infarction(STEMI),we conducted a single center clinical study of retrospective analysis of clinical conditions,laboratory test results,coronary angiography,and cardiac ultrasonography to quantitatively assess the risk factors.Methods:A retrospective analysis of 488 cases of STEMI patients in Xiamen cardiovascular Hospital Affiliated to Xiamen University from 2010 to 2014 were conducted.According to the inclusion criteria and exclusion criteria we included 37 patients in VA-group(33.9%)and 72 cases of patients in None-VA group(66.1%).We collected the data of clinical situation,laboratory test,coronary angiography and echocardiography data.And then we applied Single factor and Multivariate logistic regression analysis to quantitative evaluation the risk factors of VA formation after STEMI.Results:⑴VA formation occurred in 2.5(2.0,5.25)days after AMI.⑵In terms of clinical feature,the differences were significance between the group of VA and None-VA group in the proportion of women,age,anterior wall infarction(P=0.047,0.040,<0.001).⑶In terms of laboratory test results,two groups of patients had statistically significant differences in white blood cell count,hemoglobin levels(P=0.039,0.008).⑷In terms of coronary angiography,the anterior descending branch occlusion of the VA-group was higher than that of the None-VA group(P=0.001).⑸In the area of echocardiography,there were 35 cases(94.6%)in the left ventricular apex,one in the left ventricular posterior apical apex and one in the right ventricle Wall,of which one case had ventricular aneurysm thrombosis.Left ventricular end diastolic diameter(LVDd)enlargement,reduced left ventricular ejection fraction(LVEF)and moderate or above mitral regurgitation(MR)in VA group were higher than those in None-VA group,and the differences were all statistically significant(P<0.05).⑹Single factor Logistic regression analysis showed that female,age,anterior wall infarction,anterior descending artery occlusion,LVDd enlargement,reduced LVEF and moderate or above MR after STEMI were risk factors for aneurysm formation.⑺Multivariate logistic regression analysis showed that the anterior wall myocardial infarction and LVEF decreased after STEMI were independent risk factors of VA formation.Conclusions:VA formation occurred in 2.5(2.0,5.25)days after AMI.Female,age,anterior wall myocardial infarction,anterior descending branch occlusion,LVDd enlargement,LVEF reduction,moderate and above MR are risk factors for the formation of VA,among which the anterior wall myocardial infarction,anterior descending branch occlusion and LVEF decreased as an independent risk factor for the formation of VA.